Fill and Sign the Request to Register Foreign Order Pursuant to Rsa 458 A26 Form

NHJB-2063-F (12/01/2010) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) REQUEST TO REGISTER FOREIGN ORDER Pursuant to RSA 458-A:26 One (1) Certified Copy And One (1) Phot ocopy Of The Order Must Be Attached Support or Alimony - No filing fee Divorce, Custody, Civil Union Dissolution, Visitation, etc. - Filing Fee required 1. Your Name Telephone Date of Birth Your Address 2. Other Party's Name Telephone Date of Birth Other Party’s Address 3. List minor children born to or adopted by the parties: Name Date of Birth Current Address 4. What type of case are you asking the Court to Register? (One (1) certified copy and one (1) photocopy must be attached) Divorce/Legal Separation Custody/Parental Right s and Responsibilities Child Support Civil Union Dissolution Other 5. In what state(s) or country(ies) was this case heard? 6. What date was the foreign (out of state) order issued? 7. Is the case still pending (open) or closed? Is there a hearing scheduled? Yes No 8. If yes, what is still pending? 9. State, in your own words, why you want to register this Order: Case Name: Case Number: PETITION TO REGISTER FOREIGN ORDER IN AFFIDAVIT FORM NHJB-2063-F (12/01/2010) Page 2 of 2 Questions #10-#12 answer for SUPPORT CASES ONLY. 10. A description and the location of any property (house, cars, etc.) owned by the person ordered to pay support. 11. How much child support is owed as of this date? 12. I have notified the N.H. Division of Human Services that I am filing this petition. Yes No Sworn Statement of Petitioner: I swear or affirm to the best of my knowledge and belief that the forei gn order I seek to register has not been modified. Date Signature of Petitioner State of , County of This instrument was acknowledged bef ore me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title Signature of Attorney for Petitioner Printed Name, Address and Phone Number of Attorney Bar #